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  • Molina Healthcare Prior Authorization Request Form

Get Molina Healthcare Prior Authorization Request Form

Molina Healthcare Prior Authorization Request Form MEMBER INFORMATION Molina Medicaid Fax: (866) 4496843 Molina Medicare Fax: (877) 7082116 Molina MyCare Ohio Advanced Imaging HNCC Fax: (877) 7082116.

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Molina prior authorization form Questions & Answers

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Providers are required to have an NPI or an Administrative Provider Identification Number (APIN). 3. Practitioner must complete and submit to Molina a credentialing application. The application must be entirely complete.

Nonparticipating Providers All in-patient services require prior authorization. Please call 1-800-488-0134 to obtain prior authorization for emergency admissions. Outpatient emergency services do not require prior authorization.

Referral Required: Molina Healthcare is a primary care plan and requires a written or verbal referral from the Primary Care Provider (PCP) to specialist offices prior to sending the Member for specialist care. Please Note: Authorization requests should be submitted by the PCP or Specialist ordering the service.

Molina Health Care in CaliforniaMolina Healthcare is a FORTUNE 500 company that delivers managed health care services through Medicaid, Medicare and the Health Insurance Marketplace. Molina's locally-operated health plans serve approximately 2.3 million members in 11 states.

Become a Molina Provider Call us at (855) 322-4075. Contracted providers are an essential part of delivering quality care to our members.

Be a citizen of the United States or a legally admitted alien. Have a DON score of 29 points or more. Have less than $17,500 in assets or $35,000 family assets for a child under the age of 18. Needs will be met at a cost less than or equal to the cost of nursing services in an institutional setting.

Just use your Medicaid card. You don't need a referral from your PCP. Ask your PCP for a list of places to get these services or call Member Services at [Insert Member Services Number]. You can also call the New York State Growing Up Healthy Hotline (1-800-522-5006) for nearby places to get these services.

For providers in all networks As a reminder, on Jan. 1, 2019, Molina Healthcare updated the Authorization Reconsideration process. Pre-service and post-service authorization reconsiderations have been combined into a single process, and claims reconsiderations now follow a separate process.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232